A significant share of people in Eastern and Western European countries have skeptical attitudes toward vaccines and vaccination. Figures 1, 2, 3, and 4 provide information on the share of respondents that agree with (incorrect) statements on vaccines or vaccination. While 32% of the respondents agree with the statement that vaccines overload and weaken the immune system, the share is significantly lower in the Netherlands and Sweden (about 15%), while in Slovenia, Croatia, the Czech Republic, and Austria more than 40% agree with the statement (see Fig. 1). Figure 2 demonstrates that almost 50% of the respondents in Malta, Belgium, and Slovenia think that vaccines can cause the disease against which they protect, while only 25% and 30% agree with this statement in Bulgaria and Greece. Across Europe, almost 40% agree with the statement that vaccines can cause those diseases which they should protect against. Roughly half of the respondents across all European countries agrees with the statement that vaccines often have serious side effects. While only one third of the Dutch and the Danes agree with that statement, almost two-thirds of the respondents from Cyprus and Croatia and 60% of the French respondents think that vaccines often have serious side effects (see Fig. 3). Only 10% of the respondents across Europe disagree with the statement that vaccines are tested rigorously before authorization. There is, again, clear variation between the countries. In Romania, Croatia, and Italy, 18–20% of the respondents think that vaccines are not rigorously tested before being authorized. The share of respondents with the same position is below 5% in the cases of Eastern Germany, the Netherlands, Portugal, and Malta (see Fig. 4).
The level of cross-country variation indicates that we need to include variables that identify the respective countries and regions when estimating the impact of ideological extremity on the respondents’ positions regarding the four indicators of vaccine-skepticism. In the following paragraphs, we present the results of the multivariate analyses, so that we can evaluate whether ideological extremism matters for skepticism of vaccines and vaccination. The results of the logistic regression models presented in Table 1 provide information on why respondents agree with the statement “vaccines overload and weaken the immune system” (model 1), “vaccines can cause the disease against which they protect” (model 2), “vaccines can cause the disease against which they protect” (model 3), and “vaccines are not rigorously tested before being authorized for use” (model 4). While we find no effect of ideological extremism for support of the statement that vaccines overload and weaken the immune system in model 1, there is evidence that people who locate themselves on the far left of the ideological spectrum are more likely to support this statement (see model 3 in Table A1). This is, however, not the case for people who consider themselves as far right-wing. There is also no evidence that with more right-wing positions people think that vaccines overload and weaken the immune system (see model 4 in Table A1).
Table 1 Determinants of skeptical positions on vaccination When shifting the perspective to the statement “vaccines can cause the disease against which they protect” (see model 2 in Table 1), we find evidence that ideological extremism matters for vaccination skepticism: The more ideologically extreme respondents are, the more likely they are to think that vaccines cause diseases against which they should protect (see also model 2 in Table A2). The results of model 3 in Table A2 indicate that people from the far-right are more likely to support this statement; however, there is—again—no evidence that people are more likely to support this statement the further to the right they place themselves on a left–right dimension (model 4 in Table A2).
We find similar patterns when shifting the perspective to the statement “vaccines can often produce serious side-effects”. Here we find again that ideological extremism matters: The further away people are from the center of the left–right dimension, the more likely they are to agree with the statement that vaccines often produce serious side effects (see model 3 in Table 1 and model 2 in Table A3). Furthermore, when differentiating between people who consider themselves as far-left or far right-wing, we find that both groups of people are more likely to think vaccines often produce negative side effects (see model 3 in Table A3 in the online appendix).
Model 4 in Table 1 provides evidence that ideological extremism helps to explain why people disagree with the statement that vaccines are rigorously tested before being authorized for use. The further away people are from the center of the left–right dimension, the more likely they are to think that vaccines are not rigorously tested before authorization. Again, there is no evidence that only people who place themselves on the far-right are skeptical of testing prior to the authorization of new vaccines (see models 3 and 4 in Table A4 in online appendix).
All these results are stable, even when controlling for a battery of further variables that are usually included in empirical models when analyzing the positions and attitudes of people toward vaccines and vaccination. In line with existing studies, we find that trust in political institutions and in the media particularly matters: If people do not trust the government or the media, they are more likely to be skeptical of vaccines and vaccination. Moreover, the longer people spend in education, the less likely they are to support statements that are skeptical of vaccines and vaccination according to the findings presented here. In addition, self-reported financial problems and the feeling that one’s own views are not considered in the respective countries’ political decision-making process strengthen vaccine and vaccination skepticism. There is also evidence that a low degree of life satisfaction results in skeptical attitudes toward vaccines and vaccination, while respondents that have children seem at least less likely to agree with the statements that vaccines are rigorously tested before being authorized and that vaccines often produce serious side effects.
Overall, our findings indicate that in the case of three of the four statements regarding vaccines and the vaccination process, ideological extremism matters: the further away a respondent locates him- or herself from the center of the ideological left–right dimension, the more likely it is that he or she thinks
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that vaccines can cause the disease against which they should protect,
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that vaccines often produce serious side effects, and
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that vaccines are not rigorously tested before being authorized for use.
There is—with the exception of the statement that focused on the side effects of vaccines—no evidence that a greater right-wing orientation results in skepticism of vaccines and vaccination in the European geographical context. We therefore suggest that governments and administrations should form broad alliances and coalitions between groups and parties in society and politics in order to reduce skepticism of vaccines and the vaccination process, as this will increase the chances of more people wishing to be vaccinated against viruses that could result in a global pandemic like COVID-19. We will discuss the implications of these findings in the next section in more detail.